Under the dermoscope: Beauty spot or something more serious?

Emmaline Ashley's picture

We’re always excited to introduce new services, but we’re particularly excited about the big reveal of our brand new dermoscopy and cryotherapy services because the potential impact they could have on our patients is massive. 

In this blog I’m talking warts and small benign growths. Granted, they’re not very glamorous subjects, but I hope that by answering your most common questions around the topic of skin lesions I can help to spread awareness of a much more serious issue – skin cancer. 

Beauty spots – love them or hate them?

Benign skin lesions like moles and warts are very common. Some people positively embrace them – just think how many people over the years have tried to emulate Marilyn Monroe’s iconic look by copying her trademark beauty spot with the help of a kohl pencil! 

Some of you, however, might have a skin lesion that is bothering you. Perhaps it catches on your clothing, or perhaps you just don’t like how it looks and it’s having a real impact on your confidence. In these cases, it may be possible to have it removed in seconds at the DRVICTORIA™ Clinic, thanks to our new cryotherapy service with CryoSuccess.

But first, get it checked under the dermascope

While it is very common to want to remove an unsightly skin lesion for cosmetic purposes, it is incredibly important that the lesion is first diagnosed by an appropriate clinician before it is removed. 

If a lesion is removed without being absolutely certain as to what it is, there is a danger of a missed skin cancer diagnosis. 

Speaking from experience

Having worked on the melanoma firm of a plastic surgery team at St George’s Hospital in London, I am acutely aware of how important proper identification and full excision of skin cancer lesions is. 

Skin cancers must be fully removed with a wide margin to ensure that microscopic cancer cells at the margin of the lesion are taken away. Otherwise, we risk the cancer coming back or spreading further while also delaying proper diagnosis and treatment. 

You’re in safe hands at DRVICTORIA™ Clinic

If your aesthetician has any suspicion about a lesion you would like to have removed, they can refer you to me to have a look at your skin lesion with a dermoscope. 

A dermoscope is a specialist handheld microscope used to examine skin lesions. It is commonly used by plastic surgeons, dermatologists, and specialist GPs to examine skin structures and patterns under powerful light to aid diagnoses.

I will take a series of clinical images using the dermoscope, right here in the DRVICTORIA™ Clinic, then send them to a dermatologist referral service for a confirmed diagnosis on whether the lesion is benign or suspicious. You get seen quickly and get an answer in less than a week.

If the lesion is deemed malignant or suspicious - we can do an onward referral, so you get the help you need. If it is benign I, or a colleague, can remove it.

Introducing Cryotherapy

Cryotherapy, including the use of a CryoSuccess, refers to using cold temperatures to treat and remove benign skin lesions and is recognised by The British Association of Dermatologists (Ref 1).

Most commonly it is used to treat actinic keratosis (an area of rough, sun-damaged skin), warts, seborrheic keratosis (benign raised skin growth), vascular lesions (little abnormal blood vessel growths), and some cysts. I mostly treat warts, and small benign growths using the CyroSuccess device which uses nitrous oxide to treat lesions at a temperature of -89°C when the device’s glass tip is placed in contact with the desired lesion. 

Most patients report a a stinging sensation as the tissue is frozen and immediately afterwards there  will be some mild discomfort with swelling and redness as a blister forms on the skin in the hours after the treatment, but this should resolve on its own within just a few days. 

Complete healing typically occurs within two to four weeks for benign lesions (Ref 2).

Some skin lesions require just one treatment whilst larger ones may require more than one session. 

Whilst there is always a risk of scarring with any treatment removing a skin lesion, the advantage of cryotherapy is it has a lower risk than conventional surgical techniques. In rare cases the following can occur:

  • Keloid scarring where a harmless raised scar can form that appears rounded as a hard growth – this is extremely uncommon in Caucasian skin types.
  • Pigmentation changes where the treated area may lighten or darken. This usually improves with time and people with darker skin tones are more at risk.

Most people can have cryotherapy, but you should not if you suffer with:

  • Cryofibrinogenemia
  • Cryoglobulinemia
  • Raynaud disease
  • Agammaglobulinemia
  • and multiple myeloma
Notice something different?

If you are concerned about a skin lesion, don’t hesitate to get it examined. During a clinical consultation, the most important thing is to give a good history of the lesion. Often skin lesions can have non-specific features even on dermoscopy, but a good history describing potential red flags such as rapid growth, non-healing lesions, or persistent bleeding will help get a diagnosis. It can be a good idea to keep a photo record of a lesion so you can see clearly if it is changing over time. 

Act fast!

The most serious consequence of ignoring a worrying skin lesion is a missed or late skin cancer diagnosis. While basal cell carcinomas are slow growing and don’t tend to spread, squamous cell carcinomas can be more aggressive, and melanomas are known to metastasise – so if in doubt, get it checked out!

Prevention is better than cure

It sounds like a real cliché but prevention really is better than cure, so protect yourself from sunburn ‘By using high-factor sunscreen, dressing sensibly in the sun, and limiting the amount of time you spend in the sun during the hottest part of the day’ (Ref 3). And I don’t just mean in peak summer. You should be wearing sunscreen every day. Yes, even here in Scotland! 

That’s because regardless of how grey and dull it looks outside, you still get exposed to a certain amount of UV radiation. UV A has a longer wavelength than UV B rays (which is what we usually associate with sunburn). However, UV A rays can penetrate deeper into the skin, through cloud cover or windows, and cause skin ageing and the damage that can lead to cancer. 

Over 40? Pay close attention…

Skin lesions become more common as we age and get older. But once you hit 40, it is essential that you keep an eye out for any new moles developing and get them examined ASAP as it is rare for them to develop at this age. 

That said, anyone of any age should be vigilant, according to Harvard Health, ‘If melanoma runs in your family, if you have more than 40 moles, or if you've had several sunburns. If you fall into this category, you should get checked regularly by a dermatologist’ (Ref 4).

Book your treatment now

If you have a skin lesion that you would like checked and removed safely and quickly, book an appointment for our new dermoscopy and cryotherapy services which are available now.

Ready to help

Author's experience:

Dr Emmaline’s post-graduate training includes a Professional Certificate in Clinical Dermatology from University College Dublin and her time at St George’s Hospital, London, gaining experience in melanoma diagnosis has made her passionate about introducing dermascopy to the clinic

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Dr Emmaline Ashley

Emmaline joins us having moved up from Harley Street. Her extensive post-graduate training, including a Master of Surgery (Hons) with a research dissertation in plastic surgery from the Royal College of Surgeons Ireland and a Professional Certificate in Clinical Dermatology from University College Dublin gives her deep understanding in facial aesthetics.

Emmaline specialises in Botox, dermal filler injections, TIXEL, EndyMed and dermascopy.

Dr Emmaline Ashley BA, MCh, MBBChBAO, PGCert Derm
Doctor & Facial Aesthetics
GMC 7582958

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